He spent seven days in the hospital and the next 10 weeks, the lengthening phase, at a nearby residence. After the surgery, a sticky blood mass called a callus—the beginning of new bone—formed on each of his broken femurs. Jeff’s job was to click a remote control that signaled the rod to telescope out one millimeter a day, stretching the bone callus with it. He describes the feeling in pubescent terms, as “an intense growth spurt.” Then, during his last six to eight weeks in Germany, he waited for the bone to knit together and harden in its new, longer form.

Jeff is one of an estimated 4,000 people in the world who have chosen to undergo cosmetic limb lengthening (CLL) in recent years. “That number is increasing all the time,” says Dr. Dror Paley, an orthopedic surgeon at Sinai Hospital of Baltimore. Paley gets several e-mail inquiries about the procedure every day, the majority from affluent men between the ages of 20 and 40. “Some are very genuine,” he says, “and others are complete nutcases.”

A person could argue that to pay upwards of $100,000 for a risky, excruciating surgery that adds just a few inches to your frame is insane. CLL is by far the most extreme (and expensive) procedure that a human being can submit to in the name of vanity. Most lipo and facial-surgery patients can go home within an hour. Recovery time for calf and pec implants is a couple of weeks. And at $8,000, penile implants seem like a bargain by comparison—plus, in terms of pure physical pain, there is no contest. Beyond the agony of having your bones cut in two and stretched, CLL carries risks like pinhole infections, nerve damage, and severe deformity.

On a website called Make Me Taller, which launched two years ago, you can wade through message boards filled with self-loathing, hope, and hubris. “I would like to do 6 [centimeters] and go home sooner,” writes “12,” a patient about to undergo CLL in China. “I’ll have less possible complications and a shorter recovery time. The only thing that stops me from making that goal solid is the idea that I’ll be leaving almost an inch on the table. And yes, 2 inches is substantial, but isn’t 3 inches, like, mind-blowing?”

“What I hear is ‘People don’t take me as seriously as they would if I were taller,’” says Ellen Westrich, a psychologist who evaluates potential CLL candidates for Dr. S. Robert Rozbruch, a New York surgeon. “The dating [thing] is huge. In this culture, a certain value is placed on being taller than a woman, on being strong, being tall.” Some studies have shown that a man’s earning power and reproductive success correlate with his height. Add that information to the images of sad short-statured celebrities on shows like The Surreal Life and you can see why a man who stands well below the average American height of five feet ten deals with some very real misery.